Measurable (unintended) Effects of the War on Drugs

Measurable (unintended) Effects of the War on Drugs

The US has been in the business of preventing access to various drugs for over a century now, beginning in 1914 with restrictions on opiates. After decades of outlawing increasing numbers of drugs and enforcement of increasingly harsh penalties, President Nixon named drugs “public enemy number one” and declared the War on Drugs in 1971. Setting aside John Ehrlichman’s admission 23 years later that Nixon’s secret goal was to disrupt the organizing activities of antiwar and black activists while vilifying them in the mind of the public, the War on Drugs had a stated goal, eradicating drug use.

On its face, it seems an impossibly broad goal, since the majority of drugs consumed by Americans are medications prescribed by physicians to treat medical conditions. So the goal is pretty much understood to mean eliminating illicit use of drugs, especially for recreational purposes.

Not only are we as a nation nowhere near that goal of eradicating recreational and/or illicit use of drugs, we can’t even achieve that goal in very limited and restrictive conditions. US prisons, including maximum security prisons, routinely initiate surprise facility-wide cell searches and random drug screenings of inmates. The strictest security protocols in the nation can’t prevent the imprisoned from obtaining illegal drugs.

Has there been any partial success in the past 47 years?

The only drug to have been pretty much eliminated from illicit use in the US is quaaludes. But this drug was a unique case. It was under patent protection at the time it became popular as a club drug, and was only manufactured by one company. Quaaludes accounted for only 2% of the company’s total sales, so how hard was it to convince the company to voluntarily withdraw the product? Yeah. Even so, quaaludes are available in other parts of the world, and Customs & Border Patrol occasionally intercepts small amounts at the border. Instructions to manufacture methaqualone are easy to find online, but just reading them, the process sounds dangerous. There are other drugs that are easier to find – or make.

Other than eliminating a single party drug, pretty much a fluke, not only has there been no serious decline in the market for recreational drugs, but there have been new drugs invented (often to get around drug war restrictions) and new black markets sales for other existing drugs . Acetyl fentanyl was invented at the same time as fentanyl in 1960. Unlike fentanyl, acetyl fentanyl never been used for medical purposes, and began being used illegally in the 1980s. Some “new drugs” are just new names for old drugs – “molly” is another name for ecstasy, “cherry meth” is the old party and/or “date rape” drug GBH. Some new drugs are legally sold, such as kratom, used for at least decades in Southern Asia, but only in the US since the early 21st century, and bath salts (aka “spice’, K2, synthetic marijuana, flakka, gravel) invented in France in 1928 but part of the party scene for less than 20 years. There are some actual brand new drugs, too. Smiles (N-Bomb, 251-BOMe) came along in 2003. Europa, or 2C-E was invented in 2005, and slight variations created to get around prohibition go under the names 2C-1, 2C-T-7, 2C-B. Besides the uppers, downers and hallucinogens that constitute the party drugs, there’s an illegal market for RItalin and steroids, which are used illicitly not for fun, but to enhance performance, intellectual and physical, respectively.

Meanwhile, in the name of preventing opiates and opioids from being diverted to illicit use, increasing restrictions on legitimate prescriptions have led to real harm to law abiding patients with chronic severe pain and doctors who treat them. Paranoia levels are so high that many doctors are afraid to treat pain at all. States are enacting restrictions so harsh that even cancer patients are now finding it difficult to get adequate pain treatment. Some pain patients in desperation seek illegal sources for pain relief. Like the performance enhancers RItalin and steroids, at least some illegal use of opiates and opioids is not a recreational use.

The fact that Sudafed could be used to manufacture methamphetamines has led to restrictions on legal purchases of this over-the-counter remedy that rival the paperwork necessary to purchase a firearm. Meth continues to be available.

As in any war, truth is a casualty. In 2004, a collection of before-and-after photos was used to create “Faces of Meth”, a graphic set of images shown at numerous schools and published in the media. Multnomah County jail guard, Deputy Bret King, was inspired by the “skeletal looks” and psychotic behavior of a single inmate to search for her first mug shot, which showed her having been attractive at 20 than she appeared when subsequently arrested in 2004. Dep King was inspired to search the entire mugshot database to collect more examples of frightening metamorphoses of frequently-arrested individuals. Many of the people had teeth that looked worse over the years, a condition referred to as “meth mouth”. While attributed to the pernicious effects of meth use, bad teeth are not as rare in the region as in other parts of the US. since Multnomah County does not fluoridate its water. The photos weren’t collected as part of a longitudinal study that discovered an effect of meth use of teeth or skin, or body weight. Dep. King intentionally selected the photos depicting the most extreme declines in appearance. The population he drew from included many homeless individuals living in harsh conditions.Considering the fact that serious mental illnesses, such as schizophrenia, not infrequently become apparent in the late teens or early 20s, it’s entirely possible that the woman who inspired him could have been in terrible shape for reasons having little or nothing to do with meth.The newspaper report doesn’t say if the woman was ever tested for drugs or for any other physical or mental illness.

Now here’s an interesting thing – there is no parallel campaign to warn the public about Ecstasy Mouth – or “X Mouth.” Meth is depicted as a particularly destructive drug associated with particularly destructive – and self-destructive – behavior by users. Meth users are often depicted as twitchy, irrational, easily angered, violent, and even – like the woman who inspired “Faces of Meth” – acting psychotic. On the other hand, ecstasy is called the “Love Drug”. A 2007 New Scientist article reports that ecstasy to have “pro-social effects” and to release the love hormone oxytocin. People typically use ecstasy to enjoy music, dancing and affectionate interactions with others. Let me now blow your mind – chemically, methamphetamine and ecstasy are identical, both are MDMA. The behavior, emotions and mindset of a person using a recreational drug is apparently influenced by what people believe the drug will do. Perhaps telling an individual who has been over-using alcohol or a recreational drug that the only way to improve his situation is to admit that he can’t responsibly moderate his use might not be so helpful.

In recent years, several states began loosening restrictions on marijuana, first for medical use, then in 2014, for recreational use. This drug, which in the 1930s, Harry Anslinger claimed could cause mania and murderous psychosis, and in the 1970s was frequently claimed to turn young people into demotivated couch potatoes, is said to be by far the most used of all illegal recreational drugs. Statistics from states in which there has been full legalization show none of the mayhem, crime, violence or disruption that the drug warriors have been claiming to be the results of lifting the restrictions on drug use. You would think that an outcome in which communities not only have not seen increases, but have seen decreases in crime not just statistical decreases caused by the reduction in arrests of a no longer illegal activity, but also decreases in violent crimes and property crimes. One has to wonder if legalization of all currently-illegal drugs would have similarly benign results. Continuing to do what we have been doing since 1971 is unlikely to lead to results better than the situation we have now.

Our government has spent decades generating and spreading exaggerations and falsehoods about drugs and drug users to keep the drug war in the news cycle and keep as much public support for the drug war as possible. Just as there are fads in popularity of one recreational drug or another, there are also fads of government and media directing attention to one drug or another. As I write this, the opiate crisis is the current anti-drug narrative. I recall the previous focus was meth. It’s not like meth was wiped out and then drug warriors began to focus on opiates. Meth is still on the list of most popular and available illegal drugs. The only thing that changed was the narrative the government and media are focusing on. The “Faces of Meth” campaign has long been inactive.

The fact that random mugshots were collected for the purpose of encouraging public fear of meth and meth users, regardless of whether there was a direct demonstrable connection between the condition of the person’s appearance and meth seemed to trouble no one involved with creating, promoting or generating news reports about the use of the images. This seems to be a good illustration of the way that prohibition undermines honesty. What’s a little white lie – or an avalanche of what lies delivered via government reports, stories publicized by a media ever hungry for sensational stories, an entertainment industry for which many of the tropes that make up addiction sin-and-redemption stories were intentionally constructed – if it’s in the service of such a noble goal as eliminating harmful drugs from our society?

Prohibition has known bad effects that permeate all of society, even those not directly involved in enforcing or dodging the law. While we are willing to admit that this was the case during the short years of alcohol prohibition, the damage to our society wrought by unending years of prohibition of drugs is as invisible on a day-to-day basis as the air we breathe.

When we take a moment to consider alcohol prohibition, we can easily call to mind corruption in the form of officials and police on the take, marketing the product themselves, robbing dealers, planting evidence to justify false arrests of individuals who might not even be engaging in illegal activities, and so on. There are also parallel cases documented in relation to illegal drugs in our time. In addition, enforcement officers who do not flip and participate in the black market may try to get results with illegally brutal tactics. Elected politicians facing a black market flourishing under prohibition can claim to promote law-and-order by enacting increasingly harsh punishments.

A horrible impact on some particularly appealing individual arrested for the first time, with a tiny amount – may inspire politicians to appear compassionate by creating legislation for treatment facilities to receive funding, be made eligible for health insurance payments, or offered as an alternative to a mandatory minimum prison sentence. Such treatment facilities that might be in far less demand if they were not offered to some individuals on pain of imprisonment and a criminal record. So how bad is forcing someone to stay in a facility for treatment of a condition that individual might not even suffer, if it keeps that person out of the much harsher circumstances of a state prison? The person broke the law, yet may be encouraged to accept being labeled as needing a treatment of a quasi medical nature because the person doesn’t deserve the harshness that is mandated. Instead of questioning the morality of having laws on the books we consider too harsh to meet out onto every individual convicted under those laws, we create a partial escape hatch of a pantomime treatment for a potentially nonexistent condition, and to sweeten the pot, offer to expunge the record of anyone who successfully completes treatment and any other instructions given by the drug court judge. Those who do not successfully “graduate” from a drug-court mandated treatment program face the full sentencing and criminal record.

Failures at the government level, like a SWAT team crashing into the wrong house, or people being imprisoned because of planted evidence, are not counted against the larger goal.

Another way the drug war has changed us for the worse is the attitude toward patients who take opiate or opioid pain medications, especially those who take the medications for long periods or at high doses. Law-abiding patients with documented painful medical conditions, especially if the condition is not a terminal disease or cancer, are required to sign pain contracts requiring them to submit to urine tests on a regular schedule as frequently as once a month and or at random times at 24 hours notice, submit to pill counts, promise to never share pills even in an emergency, not drink alcohol (ignoring the fact that opiates and alcohol are not necessarily a deadly combination, as the 19th century popularity of laudanum, a mix of morphine and alcohol demonstrates), undergo psychological counseling, only use one pharmacy, not accept pain medication prescriptions. A patient following all the requirements may or may not receive ongoing medical care from the other signer of what we call a contract.

For years, the treatment of chronic severe pain has been changed from the doctor treating the condition that causes the pain also treating the pain, to patients being required to get their medications from a specialty pain clinic. This is forcing some patients who may have a more or less stable medical condition and pain medication requirements to make appointments to see a specialist not because the individual needs a specialist on top of any specialist or GP the patient already sees. Many patients don’t need the care of a pain specialist and may have even done without such services for years, but it’s better than not being able to get pain treatment at all. Right.

Drugs are understood to make a person less honest. The word of an admitted drug user is so discredited in our culture – and our courts – that the testimony of two men who witnessed Robert Blake’s preparations to kill his not-so-beloved wife Bonnie Lee Bakeley was portrayed by the defense as inherently unreliable, and was ultimately discounted because they admitted to drug use and had not sought any form of rehab. But if someone is arrested and caught with illegal opiates, even if incidental to the arrest for another crime, claims to have become hooked from an initial legal prescription, that supports the narrative we are expected to believe, even though as far back as alcohol prohibition, criminals would blame illegal booze for their crimes.

Another frequent topic for the media to report is that opiates have been killing an increasing number of people, in recent years, overtaking the numbers of deaths in auto crashes. Often, the number reported is “overdose deaths” in an article about opiates, even though the overdose number includes drugs other than opiates. Also, due to systemic irregularities in the collection of data by the 2342 offices legally responsible for death determinations around the country collecting data on different kinds of drugs in different places and over different years, it’s impossible to tell if nationwide total numbers of deaths of opiate users are going up, down or remaining steady. The CDC report “Drugs Most Frequently Involved in Drug Overdose Deaths: United States, 2010-2014,” is a source for the claim that 47,055 deaths were attributed to opiates in 2014. To be clear, the number 47,055 is the total number of deaths attributed to drug overdose, the number of deaths attributed to all opiates combined in this report is 31,271. The first page of this report states, “Relative increases in the death rates involving specific drugs and the rankings of these drugs may be affected by improvements in reporting, real increases in the numbers of death, or both.” (emphasis added)

“Opiate death” is not a conclusion of a scientific investigation. “Opiate death” is a bureaucratic category on a government form. The government generates and reports numbers based on what thousands of coroners and medical examiners record as the named cause of death, as well as from other information within the certificate. These numbers are reported by the government and the media as if it were the fruit of properly designed scientifically collected data. But most people who die in America are not autopsied, and 2/3 of Americans live in a jurisdiction with an elected coroner, likely with no scientific or medical credentials. The offices responsible for investigating deaths are chronically understaffed, 2/3 have no in house toxicology lab, 2/3 have no histology (tissue) lab, 1/3 no in house x-ray machine. Coroners and the federal employees who compile numbers of deaths attributed to opiates rely on the declared cause of death, as well as any clues noted at the scene of the death (e.g., a pill bottle, possession of a prescription, needle) or comments by loved ones.

The death determination for Supreme Court Justice Antonin Scalia was made by telephone by a coroner who never saw his body, after no forensic examination of the body or the scene, and released the body for immediate cremation. His death is legally counted as a heart attack the same as someone who died in a hospital, where there’s an archived record of the information recorded by a heart monitor in the moments before death.

The Boston Globe had a headline in 2018 that reads, “One-quarter of Mass. residents know someone who died from opiates.” The article cites a number of 2,000 deaths in Massachusetts in 2016 attributed to opiates. The writer of the article did not do the arithmetic that I did. Massachusetts 2016 population was 6,811,779. For those 2,000 deaths to have touched one-quarter of the population, 1,702,945 friends and family, each of the departed would have had to have had like 851 acquaintances – not counting out-of-state friends and family, and without overlap among the social circles of the deceased. Those 2,000 were 0.02% of the total state population, and 5.9% of the 33,953 deaths in Massachusetts that year. But if the reporting on those deaths scares someone into not starting, or quitting, use of illegal opiates, that would be worth the orders of magnitude exaggeration of the impact of opiate deaths. Right.

A seemingly small thing would be inaccuracy in our word choice. “Narcotics” is used as a synonym for “scary drug”, or even any illegal drug, when it actually refers only to active ingredients from or synthetic analogs of opiate poppies. Marijuana, meth, cocaine, PCP, LSD, and so on, are not narcotics at all. But we, and our elected officials and law enforcement personnel and media call all these things, and more, “narcotics.” It’s just sloppy language. Everybody knows what “narcotics” means.

Depending on how you measure it, we have been at this drug prohibition project for a half a century or a full century. Anyone who wants to, and has a bit of cash and determination, can purchase chemical or plant-based products selected to generate any state of mind from mellow, to giggly, to spiritually engaged, to affectionate, to energetic, as well as some enhancements of mental or physical performance.

The degrading effects of prohibition are capable of spreading from the most powerful and intimidating uses of power within our society to things as small as misuse of a single word.

do people still use q? http://www.newsweek.com/do-people-still-take-quaaludes-357914
(interesting, US CBP 2014 cocaine confiscations totaled 1626 seizures – doesn’t sound like much for a country of 300+million)

how to make (sounds dangerous) https://www.erowid.org/archive/rhodium/chemistry/quaalude.cheapskate.html

Most popular drugs from government publications 2016
https://www.drugabuse.gov/publications/media-guide/other-commonly-used-addictive-drugs
(this also lists the chemical name of molly/ecstasy: 3,4-methylenedioxymethamphetamine)